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SynopsisCodesDifferential Diagnosis & PitfallsBest TestsReferences
Tricuspid regurgitation
Other Resources UpToDate PubMed

Tricuspid regurgitation

Contributors: Christine Osborne MD, Ryan Hoefen MD, PhD
Other Resources UpToDate PubMed

Synopsis

Tricuspid regurgitation (TR) refers to the backflow of blood from the right ventricle (RV) to the right atrium due to insufficiency of the tricuspid valve. In 80% of cases, TR is due to dilation of the tricuspid annulus from RV dilation in the setting of pulmonary arterial hypertension.

Other causes of TR include inferior myocardial infarction (MI), heart failure secondary to rheumatic heart disease, heart failure secondary to congenital heart disease with severe pulmonary artery hypertension, ischemic cardiomyopathy (see coronary artery disease), idiopathic dilated cardiomyopathy, infarction of the RV papillary muscles, tricuspid valve prolapse, infective endocarditis, radiation, endomyocardial fibrosis, or leaflet trauma. The most commonly associated congenital heart disease occurs with Ebstein malformation of the tricuspid valve.

Symptoms of TR include exertional dyspnea, fatigue, abdominal fullness, decreased appetite, lower extremity edema, and progressive weight gain. Physical examination reveals prominent c-v waves with rapid y descents, hepatomegaly with hepatojugular reflex, ascites, pleural effusions, peripheral edema, and a blowing holosystolic murmur along the lower left sternal border, typically with atrial fibrillation.

Codes

ICD10CM:
I36.1 – Nonrheumatic tricuspid (valve) insufficiency

SNOMEDCT:
111287006 – Tricuspid valve regurgitation

Differential Diagnosis & Pitfalls

  • Pulmonary hypertension
  • Pulmonary embolism
  • Chronic obstructive pulmonary disease
  • Congestive heart failure
  • Pericardial effusion
  • Acute liver failure
  • Renal failure (Acute kidney injury, Chronic kidney disease)

Best Tests

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References

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Last Updated:05/30/2023
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Tricuspid regurgitation
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A medical illustration showing key findings of Tricuspid regurgitation : Heart murmur, Peripheral leg edema, Dyspnea
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